Half-effective Target Effect-site Concention Of Sufentanil Required To Inhibit Body Movement During Insertion Of Ureteroscope When Combined With Propofol

Objective To determine the half-effective target effect-site concentration (EC50) of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol in patients undergoing transureteroscopic holmium laser lithotripsy.Methods Fifty ASAⅠorⅡpatients of both sexes aged 20-60 yr, BMI<30 kg/m2, undergoing transureteroscopic holmium laser lithotripsy were randomly divided into 5 groups according to the different Ces of sufentanil (n=10 each):group S1(0.21ng/ml), group S2(0.14ng/ml), group S3(0.09ng/ml), group S4,(0.06ng/ml), group S5(0.04ng/ml). Anesthesia was induced with propofol TCI. The initial target plasma concentration (Cp) was set at 2.5μg/ml. If the patient remained conscious 5 min after the equilibrium between Cp and target effectsite concentration was achieved, the Cp of propofol was increasing in thcrements of 0.2μg/ml until consciousness was lost. Propofol TCI was maintained at this level. TCI of sufentanil was then started at the different Cp set in the 5 groups. The ureteroscopes were inserted as soon as the patients lost consciousness and the effect-site concention of sunfentanil achieved. The response was defined as positive when body movement occurred within 1 min after insertion of ureteroscopes. The EC5o of ufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol and 95% confidence interval (CI) were calculated. Blood pressure, heart rate, SpO2 and the amount of body movement in every group were monitored.Results The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol was 0.084ng/ml with 95% CI was 0.066～0.107ng/ml. There was no significant difference in the HR and MAP among the five groups (p>0.05). The MAP was significantly lower after induction than before induction in group S2 and group S2 (P<0.01).Conclusion The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol. The Hemodynamic was more stable when the concentration of sufentanil was not higher than 0.14 ng/ml.